Test 54 - Created Aug 15

Question 1

tx of viral gastroenteritis

Answer 1

oral rehydration and avoid fruit juice (can make things worse)

Question 2

what can help lower risk of developing atopic dermatitis

Answer 2

early exposure to nonpathogenic microorganisms (day care, farm animals, household dogs), breastfeeding, emollients

Question 3

multiple linear regression vs multiple logistic regression

Answer 3

linear - evaluates associations btwn 1 quantitative dependent variable and 2/+ independent variables (ex. RFC vs. BMI, plt count, Cr Cl)

logistic - evaluates associations btwn 2/+ independent variables and 1 dichotomous dependent variable (ex. obesity, age, smoking vs. DM/no DM)

Question 4

empiric tx for meningoencephalitis

Answer 4

acyclovir, vanc, ceftriaxone

watch out for age of pt

Question 5

type of cells that proliferate and make acoustic neuromas in neurofibromatosis

Answer 5

Schwann cells

Question 6

post exposure prophylaxis for meningococcal meningitis

Answer 6

• rifampin BID x2d - do NOT give in pt on OCPs
• ciprofloxacin x1
• CTX x1

Question 7

tx of choice in hemodynamically significant bradycardia (pulm edema, htn, cold limbs) from an MI

Answer 7

IV atropine

Question 8

MC bugs in cellulitis versus abscess

Answer 8

C: strep pyogenes
A: staph aureus

Question 9

if PCI not possible for a STEMI patient, what do you give? (beyond normal things)

Answer 9

fibrinolytic therapy (tenecteplase, alteplase, reteplase)

Question 10

ECG findings diagnostic of STEMI

Answer 10

ST elev in 2/+ cont. leads:
>1 mm in those leads except V2 and V3 (next line)
>1.5(F), >2(oM), >2.5(yM) in leads V2 and V3

new LBBB w/ ACS sxs

Question 11

when are larger sample sizes needed

Answer 11

when a higher level of power is required or when differences btwn groups are small

Question 12

tx of hyperthyroidism in pregnancy

Answer 12

1st tri: PTU
2nd tri: methimazole
3rd tri: methimazole

Question 13

presentation of fat embolism

Answer 13

24-72 hrs after severe trauma -> resp. insuff., neuro impairment, petechial rash (classic triad), also fever, tachycardia, AMS

Question 14

what reduces the chances of fat embolism

Answer 14

early immobilization and operative fixation of fractures

Question 15

what should be done asap in a patient recovering from critical illness

Answer 15

early physical therapy for progressive mobilization, which will help facilitate recovery from delirium and liberation from mechanical ventilation

Question 16

triad of PCOS

Answer 16

irregular menses, androgen excess, polycystic ovaries on U/S

Question 17

2 murmurs that become less prominent with increased venous return

Answer 17

MVP and HoCM

Question 18

murmur of MVP

Answer 18

nonejection click and systolic murmur of MR; click and murmur may change based on body position

Question 19

evaluation of bone mets

Answer 19

osteoblastic (prostate, small cell, Hodgkin) - get radionuclide bone scan

osteolytic (myeloma, non-small cell, non-Hodgkin lymphoma) - get xray, PET, or PET/CT

mixed (breast) - PET/CT, MRI, or bone scan

Question 20

tx of comedonal acne (black heads)

Answer 20

topical retinoids; salicylic acid

Question 21

tx of inflammatory acne (white heads)

Answer 21

mild: topical retinoids + benzoyl peroxide
mod: add topical Abx
severe: add oral Abx

Question 22

tx of nodular (cystic) acne

Answer 22

mod: topical retinoid + benzoyl peroxide + topical Abx
severe: add oral Abx
unresponsive: oral isotretinoin

Question 23

tx of partial SBO (see some air in distal colon)

Answer 23

admit for obs and give supportive tx (IVF, NG suction)

if fails to improve in 12-24h, call surgery

Question 24

who should get an implantable cardioverter-defibrillator in HoCM pt

Answer 24

fhx of SCD, syncope, nonsustained V.tach on Holter, htn in response to exercise, extreme LVH, survivor of cardiac arrest, sustained spont. ventricular arrhythmias

Question 25

what to do if pt with (+) results refuses to disclose info to family members

Answer 25

physician should discuss the reasons why in a supportive manner and respect the patient’s decision; physician has an obligation to report the results only if harm to an identifiable individual is evident

Question 26

presentation and tx of tinea capitis

Answer 26

scaly, red patch w/ hair loss on scalp; +/- black dots; +/- tender LAP

tx = oral griseofulvin or terbinafine (had to be oral to penetrate hair follicles

Question 27

tx of tinea corporis

Answer 27

topical terbinafine

Question 28

effectiveness of contraception: best to least

Answer 28

IUD or implant -> injection -> pills/patch/ring -> condom -> withdrawal

Question 29

1st line contraceptive for adolescent

Answer 29

IUDs or subdermal implants

Question 30

possible mgt option for hyponatremia in HF pt

Answer 30

adjust diuretic dosages, water restriction, and tolvaptan (vasopressin-2 receptor antagonist)

Question 31

presentation of rectal prolapse

Answer 31

abd. discomfort, straining or incomplete bowel evacuation, fecal incontience, digital help for defecation, red mass extending through anus with concentric rings (full-thickness) or radial invaginations (non-full thickness)

Question 32

tx of rectal prolapse

Answer 32

non-full thickness: fiber/fluids, pelvic floor exercises, biofeedback

full thickness or debilitating sxs: surgery